Lymphoma in Children and Young Adults

Lymphoma is one of the most common cancers in children. Other common cancers in children include leukemia and brain and central nervous system cancers. Lymphoma also occurs in adults, but cancers in children are often different than cancers in adults. While cancers like lymphoma tend to be more aggressive in children than adults, these types of cancer generally respond well to treatment. Children are also typically able to better handle stronger, more intense courses of chemotherapy, and more children are surviving cancers like lymphoma now than ever before.1,2

About lymphoma

Lymphoma is a cancer that is found in the lymphatic system, which is comprised of the lymph nodes, lymphatic vessels, and several organs. Lymphomas develop from lymphocytes, white blood cells that play an important role in the immune system. There are two major types of lymphoma: Hodgkin lymphoma (also called Hodgkin disease) and non-Hodgkin lymphoma. Both Hodgkin and non-Hodgkin lymphoma generally develop from either the T cell or B cell lymphocytes, although B cell lymphomas are much more common.2,3

Hodgkin lymphoma is most common in two age groups: people aged 15 to 40, and older adults after age 55. The childhood form of Hodgkin lymphoma is relatively rare in children. Most cases of Hodgkin lymphoma are characterized as classic Hodgkin lymphoma (cHL), which is defined by a specific type of cell called Reed-Sternberg cells.3,4

Non-Hodgkin lymphoma (NHL) accounts for approximately 7% of all cancers in young people under age 20, and about 5% of cancers in children aged 14 and younger. NHL is more common in boys than girls. There are more than 60 subtypes of NHL, generally characterized as indolent (slower growing) or aggressive (faster growing). Most children with NHL have the aggressive form of the disease.2,3

What causes lymphoma in children?

Most cases of lymphoma do not seem to occur from inherited mutations (those passed from parent to child). Researchers have found that lymphomas occur due to changes in the DNA, which may be spontaneous or occur as a result of exposure to certain environmental factors.2

What factors increase a child’s risk of developing lymphoma?

Some children with lymphoma have no known risk factors, or they may only have one or two. Risk factors that have been identified as potentially increasing an individual’s chances of developing lymphoma include:

Having an immune deficiency, which may be due to an inherited condition (like ataxia-telangiectasia, Bloom syndrome, severe combined immunodeficiency syndrome, or Wiskott-Aldrich syndrome), or due to medications like those for organ transplant recipients

What are common symptoms of lymphoma in children?

Many of the general symptoms of blood cancers can also be caused by other conditions, so it is important to be evaluated by a healthcare professional to determine the cause of these symptoms. In addition, not every child with a given blood cancer has the same symptoms. General symptoms that may be caused by certain blood cancers include:

The feeling of fullness in the abdomen may be due to the liver or spleen becoming swollen and putting pressure on the stomach. If this occurs, a child may not be hungry or may stop eating after only a small amount of food.2,4

Enlarged lymph nodes that occur in the chest can cause coughing, or a child may complain that breathing is more difficult.2,4

How is lymphoma staged in children?

Hodgkin lymphoma may be classified in children and young adults as Stage I, II, III, or IV. These stages may be further subdivided to indicate if cancer has been found in lymph nodes throughout the body. The staging of childhood Hodgkin lymphoma may also include A, B, E and S.

A is defined as no symptoms.

B is defined as experiencing symptoms like fever or weight loss.

E is defined as cancer found outside of the lymph system.

S is defined as cancer found in the spleen.3

Non-Hodgkin lymphoma may be classified in children and young adults as Stage I, II, III, or IV. The terms low-stage, also called limited stage, and high-stage can also be used.2,3

What is the prognosis of childhood lymphoma?

Many advancements have been made in treating lymphoma and in treating cancers in children, and the survival rates have been increasing over the past several decades. Prognosis is dependent on many things, especially the particular subtype of lymphoma and how it responds to treatment.2

Survival rates are based on past data of people who survive a set amount of time after diagnosis. In cancer estimates, experts use the “five-year survival rate” as a marker. However, it is important to keep in mind that many people live beyond five years after diagnosis and the statistics are not necessarily predictive for any one individual. The five-year survival rate for Hodgkin lymphoma in children is approximately 98%, and the five-year survival rate for non-Hodgkin lymphoma in children is approximately 91%.4

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